27 September 2013

Dextropropoxyphene and Paracetamol

The combination of dextropropoxyphene and paracetamol is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.

The combination of dextropropoxyphene and paracetamol is the active
ingredients found in Distalgesic (Nappi code: 720615-003) and Doxyfene (Nappi
code: 721212-018/026).

General informationThe combination of dextropropoxyphene and
paracetamol is a potent analgesic. An analgesic is a substance which reduces or
eliminates pain.

In South Africa this combination is registered for the treatment of mild to
moderate pain. It is also effective in reducing fever.

Paracetamol is the analgesic of choice for mild to moderate pain and to
reduce fever. It is suited for both adults and children and, as it does not
cause stomach irritation, it is safe to use by those who suffer from peptic
ulcers and those who cannot take aspirin.

When taken by mouth it is rapidly absorbed into the body and will be
effective within 30 minutes. Paracetamol is safe for occasional use by those
being treated with anticoagulants.

Dextropropoxyphene is effective in relieving pain that does not respond, and
by combining it with paracetamol, dextropropoxyphene provides an additive
analgesic effect. It should be used with caution in those patients with a
history of alcohol or drug abuse, as definitive risk of dependency does
exist.

It should be noted that pain is a symptom and not a disease, and although
this combination may be useful for short-term pain management, long-term relief
often requires treatment of the underlying cause. None of the ingredients in
this combination cures the underlying condition responsible for pain or fever,
but simply keeps the symptoms under control.

A combination product such as this is helpful in reducing the number of
tablets taken for pain management.

How does this combination work?Paracetamol blocks the production
of chemicals in the body that are responsible for pain and fever, while
propoxyphene exerts its effect by acting on parts of the central nervous system
which process pain signals.

Fast facts

Drug schedule: schedule 5Available as: the combination of
dextropropoxyphene and paracetamol is available as tablets and
capsulesWhat does it do? the combination of dextropropoxyphene and
paracetamol reduces or eliminates pain.Overdose risk:
highDependence risk: highIs this combination available as a
generic? noIs this combination available on prescription only?
yes

User information

Onset of effect: within 60 minutesDuration of action: up to
6 hoursStopping this medicine: treatment with this combination can be
safely stopped if no longer needed. If it has been used for extended periods of
time your doctor may need to gradually reduce your dose.Prolonged
use: the likelihood of adverse effects increase with prolonged use.
Prolonged use is furthermore not advised tolerance and dependence may occur.

Consult your doctor before using this drug if:

you have asthma

you have kidney or liver disease

you have a history of alcohol or drug abuse

you have a head injury

you have epilepsy

you have difficulty urinating

you have a bleeding disorder

you have a thyroid disorder

Pregnancy: avoid. Potential risk to the foetus has been reported.
Consult your doctor before use, or if you are planning to fall
pregnant.Breastfeeding: avoid. It is unknown how this medication may
affect your baby. Consult your doctor before use.Porphyria: this
medication is safe to use.Infants and children: this medication is
not intended for use in children.The elderly: caution is advised in
the elderly as an increased risk of adverse effects exists.Driving and
hazardous work: caution is advised as use of this medication may lead to
dizziness, light-headedness and/or sedation. Avoid such activities until you
know how this medication affects you.Alcohol: avoid concomitant use
of alcohol with this medication as it may worsen stomach irritation and sedative
effects.

Possible side effects

Side Effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

constipation

X

X

nausea / vomiting

X

X

drowsiness/ dizziness/ light-headedness/ sedation

X

X

headache

X

X

visual disturbance

X

X

euphoria

X

X

change in mood

X

X

rash/itchy skin

X

X

slurred speech

X

X

difficulty breathing

X

X

seizures

X

X

seizures

X

X

yellow-tinged skin and eyes

X

X

Interactions

Drug interactions:

blood pressure medication

reduced pressure-lowering effect

alcohol

increased risk of liver damage

warfarin

risk of bleeding

atropine and related drugs

increased risk of constipation, urinary retention, etc.

carbamzepine

increased risk of carbamazepine toxicity

cholestyramine

reduced effect of paracetamol

drugs that may cause sedation

increased risk of sedation

drugs for treating diarrhoea

risk of severe constipation

monoamine oxidase inhibitors

increased risk of low blood pressure

chlorpromazine

increased painkilling effect

isoniazid

risk of paracetamol toxicity; therapeutic doses may not be safe

metoclopramide, domperidone

risk of paracetamol toxicity

oral contraceptives

reduced paracetamol effect

Disease interactionsConsult your doctor before using this drug if
you have asthma, kidney or liver disease, a history of alcohol or drug abuse, a
head injury, epilepsy, difficulty urinating, a bleeding disorder, or if you have
a thyroid disorder.

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